1. СЗГМУ им. И. И. Мечникова, Санкт-Петербург (Санкт-Петербург, Россия)
2. Гос. НИИ ОЧБ ФМБА России (Санкт-Петербург, Россия)
3. Институт экспериментальной медицины (Санкт-Петербург, Россия)
4. ПСПбГМУ им. акад. И. П. Павлова (Санкт-Петербург, Россия)

Ключевые слова:бутират,дисбиоз толстой кишки,микробиота кишечника,целиакия,язвенный колит

Резюме:Цель исследования: изучить количественный состав некоторых представителей симбиотической микробиоты толстой кишки и выявить особенности дисбиоза кишечника у пациентов с язвенным колитом и целиакией. Материалы и методы: В исследование было включено 40 пациентов с активным язвенным колитом (легкая и среднетяжелая атаки), получающих терапию препаратами месалазина, 43 пациента с целиакией, находящихся на безглютеновой диете, и 42 практически здоровых добровольца. Для количественного определения микроорганизмов ДНК, выделенную из образцов кала, подвергали полимеразной цепной реакции (ПЦР) в режиме реального времени. Результаты: У пациентов с язвенным колитом, как и у больных целиакией, количество Faecalibacterium prausnitzii было значимо меньше, чем у здоровых лиц (p = 0,043 и p = 0,036 соответственно). Общее количество бутират-продуцирующих бактерий, имеющих ген бутирил-КоA: ацетат-КоA-трансферазы (but), было снижено (по сравнению со здоровыми добровольцами) только у пациентов с язвенным колитом (p = 0,048). Несмотря на то, что общее количество бактероидов между группами пациентов не различалось, Bacteroides thetaiotaomicron существенно реже встречался у пациентов с язвенным колитом, чем у здоровых лиц (p = 0,016). Отсутствие Bacteroides thetaiotaomicron в кале или его уровень ниже порога обнаружения были значимо связаны с язвенным колитом (ОШ = 6,30; 95% ДИ: 1,33 - 29,95). У пациентов с целиакией уровень Bifidobacterium spp. был значимо снижен по сравнению как со здоровыми добровольцами, так и с больными язвенным колитом (p = 0,022 и p = 0,046 соответственно). Как при язвенном колите, так и при целиакии таксономический дисбиоз характеризовался повышенным отношением Bacteroides fragilis spp. к Faecalibacterium prausnitzii по сравнению со здоровыми лицами (p < 0,05 в обоих случаях). Выводы: Повышенное отношение Bacteroides fragilis к Faecalibacterium prausnitzii может рассматриваться в качестве потенциального биомаркера дисбиоза кишечника провоспалительного типа. Уменьшение численности бутират-продуцирующих бактерий подтверждает целесообразность восполнения дефицита масляной кислоты при обоих заболеваниях путем дополнительного назначения препаратов масляной кислоты, пробиотиков на основе бутират-продуцирующих бактерий, бутирогенных пребиотиков и метабиотиков. Bacteroides thetaiotaomicron может играть защитную роль в организме человека, возможно, предохраняя его от развития воспалительных заболеваний кишечника. Снижение уровня Bifidobacterium spp. у пациентов с целиакией может свидетельствовать о защитной функции некоторых видов бифидобактерий и целесообразности применения пробиотиков на основе бифидобактерий и пребиотиков инулинового типа.

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Опубликовано :
МИКРОБИОТА КИШЕЧНИКА ПРИ ЯЗВЕННОМ КОЛИТЕ И ЦЕЛИАКИИ. Экспериментальная и клиническая гастроэнтерология. 2017;137(01):08-30
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